Provider Demographics
NPI:1437670726
Name:LOR, NINA T (PHARMD)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:T
Last Name:LOR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9555 FLAHERTY ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-1644
Mailing Address - Country:US
Mailing Address - Phone:626-548-1661
Mailing Address - Fax:
Practice Address - Street 1:36919 COOK ST STE 102
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-6069
Practice Address - Country:US
Practice Address - Phone:626-548-1661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-28
Last Update Date:2017-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH76297183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist